In our practice, we routinely use the EnSeal device to seal the ileocolic vessels and the inferior mesenteric artery and vein (IMA, IMV). Data with good evidence of the diameter (external or internal) of the inferior mesenteric artery is not widely available. However, we were able to find some data that can provide a little information. In a study by Yekeler et al, the investigators used ultrasound technology to determine the internal diameter of the superior mesenteric artery (SMA). In their study, they found that in healthy patients the internal diameter average was 5.8 mm. Among their findings is a pattern of significantly increased internal diameter in patients with active inflammation compared to patients with quiescent disease.18 We have long suspected that in tissue experiencing acute or chronic inflammation the feeding vessel will be larger; their evidence supports this hypothesis. In a very small study examining the use of the IMA for coronary artery bypass grafts, researchers harvested two IMAs and measured one of them. This artery had a 4 mm diameter at its origin. The IMA is smaller than the SMA in the vast majority of patients. Therefore, the findings by Shatapathy are consistent with this expectation.19 In our practice, we have gravitated towards the EnSeal. We find that it is effective, reliable and its versatility is evidenced by its use as a grasper, dissector, scissors and vessel and soft-tissue sealer. The nano-particles that are within the jaws of the device to regulate current and heat distribution serve to protect the adjacent tissue from thermal injury. Such injuries from other devices have been documented and often present with late and serious complications.21 As part of our normal surgical practice, we use the EnSeal to divide and seal the inferior mesenteric artery and vein when their resection is indicated. In our experience with this device, it has a low failure rate. We have not experienced any post-operative bleeding that requires transfusion or re-operation. Even though we believe that the majority of IMAs we encounter are below the 7 mm size, most surgeons do not feel comfortable using the EnSeal to seal this vessel and will use staplers to divide them.